[Bisphosphonates in anti-osteolytic therapy of metastasizing breast carcinoma]

Bisposphonates are pyrophosphate analogues and in the human organism are similarly bound to hydroxlapatite. By various mechanisms, bisphosponates inhibit the activity of the osteoclasts. Due to this characteristic feature they are exceptionally well suited to prevent bone destruction. Breast cancer is often complicated by skeletal metastases, associated with such typical complications as pain, pathologic fractures, hypercalcemia, aso. Bisphosphonates, in an adequate dose, reduce the rate of skeletal complications. The present publication is an overview on pharmacological aspects and therapeutic indications of bisphosphonates. Therapeutic guidelines on dosage and duration of therapy are given for individual indications. The palliative character of these substances is underlined and antiosteolytic treatment is described as the third pillar (beside hormone and chemotherapy) of systemic therapy of breast cancer with bone metastases. Subsequently, the most common side effects and complications are described. Bisphosphonates have osteoprotective characteristics and, possibly, could play a role in prophylaxis of ossary metastases.